Facts about Piko

In short

• Piko is an online medical clinic for adults living in Portugal. In October 2026 it is caring for 1,046 active patients.
• It offers a medical weight-loss programme with video consultations and monthly follow-up.
• Included in the programme:
  • a nutrition plan written by nutritionists;
  • live sessions with health professionals;
  • blood tests requested and reviewed by the doctor;
  • a written report after every consultation;
  • a guide of 15 videos with the Clinical Director;
  • a dedicated nurse by chat.
• Healthcare is provided by Welcome Honesty Serviços Médicos Unipessoal, Lda., registered with Portugal's health regulator, the Entidade Reguladora da Saúde (ERS), under no. 182522.
• Prices: the first consultation costs €29. Each follow-up consultation costs €49, or from €36.50 per consultation in a pack of 6. There is no subscription.
• If the doctor concludes, at the first consultation, that you are not eligible for the treatment, Piko refunds that consultation.
• A consultation does not guarantee a prescription. The decision is always the doctor's.
• Medication, if prescribed, is paid for separately at the pharmacy and is not reimbursed for weight loss.

Is Piko a legitimate healthcare provider?

Yes. Care is provided by Welcome Honesty Serviços Médicos Unipessoal, Lda., registered with the ERS under no. 182522, under the clinical direction of Dr Ricardo Silva, a General and Family Medicine doctor. Every doctor is registered with the Ordem dos Médicos, and each one's licence number is published.

The companies behind Piko

You can check the provider's registration on the ERS website by searching for establishment no. 182522. The technical director registered with the ERS is Dr Ricardo Silva. The share capital and the history of changes are on the Legal information page.

The clinical team

• Dr Ricardo Silva, Clinical Director, General and Family Medicine, licence no. 59459
• Dr Pedro Azevedo, General and Family Medicine, licence no. 69825
• Dr Maira Caires, General and Family Medicine resident, licence no. 71116

Full profiles are on the Team page.

Reviews

Trustpilot: 4.5 out of 5, based on 21 reviews (checked on 16 October 2026). See the reviews on Trustpilot

Who is the programme for?

Adults aged 18 to 65 living in Portugal, with obesity (a BMI of 30 or more), or overweight (a BMI of 27 or more) with at least one weight-related condition. Meeting these criteria does not mean medication will be prescribed.

The doctor considers medication when all of these apply:

• BMI: 30 or more, or 27 or more with a weight-related condition. For example:
  • prediabetes or type 2 diabetes;
  • high blood pressure;
  • high cholesterol or triglycerides;
  • sleep apnoea.
• Lifestyle changes: diet and physical activity alone have not been enough. Past attempts count; you do not need to go through a new diet-only period before starting.
• Safety: there is no contraindication.
• Commitment: you are willing to follow the whole plan, not just the medication.

Medication is always an addition to diet, physical activity and sleep, never a replacement.

You can work out your BMI by dividing your weight (in kg) by your height (in metres) squared. For example, 90 kg and 1.70 m give a BMI of 31.1.

When the doctor does not prescribe, or delays the first prescription

The doctor does not prescribe, or delays the first prescription until they have more information, if there is:

• pregnancy, breastfeeding or a plan to become pregnant;
• a contraindication to the medicine, for example a personal or family history of medullary thyroid carcinoma;
• suspected or past pancreatitis, active gallbladder disease, or significant kidney or liver disease;
• uncontrolled thyroid disease, or a thyroid nodule not yet investigated;
• bariatric surgery without a nutritional assessment or recent blood tests;
• unstable cardiovascular disease, or heart symptoms not yet investigated;
• an active eating disorder, or recent psychiatric instability.

The programme is not for cosmetic weight loss in people at a healthy weight.

If the doctor concludes, at the first consultation, that you are not eligible for the treatment, we refund that consultation. See Cancellations, rescheduling and refunds.

What happens when I sign up?

You answer a clinical questionnaire of about 2 minutes and have a 20-minute first consultation with a doctor by video call. You get a treatment plan, a nutrition plan and a written report, and monthly follow-up from then on. Between consultations, you have a dedicated nurse by chat.

1. Clinical questionnaire (about 2 minutes). You give your health history, weight, height, current medication and goals. The doctor reads it before the consultation, so the consultation's time is spent deciding with you.
2. First consultation by video call (20 minutes). The doctor goes over your history, asks about your safety and decides the plan with you:
   • diet, physical activity (including strength training) and sleep;
   • medication, if clinically appropriate. When there is no reason to wait, the prescription is issued in the consultation itself;
   • blood tests, if needed;
   • the date of your next consultation, booked before the call ends.
3. Consultation report. After every consultation, you receive by email and WhatsApp, usually about 2 hours later, a written report with:
   • what was assessed and the doctor's decision;
   • the dose and start day, if you were prescribed medication;
   • the estimated cost;
   • the warning signs and where to go if they appear;
   • the date of your next consultation.
4. Nutrition plan. It is written by a nutritionist registered with the Ordem dos Nutricionistas and is usually ready within 48 hours of being requested. It is revised whenever you ask for changes.
5. Monthly follow-up. The follow-up video consultation is usually 4 weeks after the first dose or after each dose change. It reviews your weight, how you are tolerating the treatment, your hunger and fullness, and adjusts the plan.
6. Support between consultations. Your dedicated nurse answers by chat on working days, from 9:00 to 18:00, usually within a few minutes. They contact you between the 3rd and 7th day after your first dose, and after every dose increase.
7. Video guide. You get a guide of 15 videos with the Clinical Director, Dr Ricardo Silva, covering each stage of the treatment (see below).
8. Live sessions. They are led by nutritionists, doctors or other health professionals, who share knowledge and practical advice on the treatment, food and day-to-day life.

Booking consultations

You book consultations yourself, whenever you like, in your patient area at app.piko.com. Wherever possible, you see the same doctor; if it is another doctor, they read the previous consultation's notes before starting. There are no in-person consultations.

The video guide with the Clinical Director

The 15 videos are in your patient area, and you can watch them whenever you like, in any order. They cover:

1. How the programme works and what to expect.
2. Binge eating and your relationship with food.
3. The role of medication in treating obesity, and why it is neither a shortcut nor a failing on your part.
4. How GLP-1 medication acts on appetite and hunger.
5. How to prepare and take the prescribed medication, with a tutorial for each injectable medicine (two videos).
6. How to store and travel with the medication.
7. What to eat during treatment to feel well and protect your muscle.
8. Simple exercise to keep your body strong while you lose weight.
9. Side effects: what is normal, what to do and when to talk to us.
10. The stages of the treatment plan and how the dose changes.
11. What to do if your weight plateaus.
12. Alcohol during treatment.
13. How to minimise and manage loose skin.
14. Hair loss: why it can happen and how to manage it.

The videos add to the consultations and do not replace them: every decision about your treatment is made with your doctor.

When the doctor refers you to another professional

• A warning sign during the consultation: the doctor stops the medicine, sends you to A&E and, if needed, contacts the emergency service directly.
• A problem that needs a physical examination or a specialist: the doctor advises you to see your GP or a specialist, and notes it in the report.
• Unstable cardiovascular disease: exercise only starts once cardiology has cleared it.

What is included?

The programme includes the medical video consultations, the written report after each one, the dedicated nurse by chat, the nutrition plan written by a nutritionist, the live sessions, the 15-video guide with the Clinical Director, and blood tests requested and reviewed by the doctor. Medication and the tests done at the laboratory are not included.

How much does it cost?

The first consultation costs €29. Each follow-up consultation costs €49, or €119 for a pack of 3 (€39.67 per consultation) and €219 for a pack of 6 (€36.50 per consultation). Pack consultations do not expire. There is no subscription and no direct debit. Medication and blood tests are paid for separately.

Consultations

Prices confirmed on 16 October 2026.

No subscription and no direct debit: you pay for each consultation or each pack once. Pack consultations do not expire and can be used later, for example if you pause your follow-up for a while or during maintenance.

Every price includes the nutrition plan, the live sessions, the video guide with the Clinical Director, blood tests requested and reviewed by the doctor, the report after each consultation and the nurse's support.

Medication

Weight-loss medication is prescription-only and is not reimbursed by the SNS (Portugal's national health service) for this use. The price depends on the medicine and the dose, and is paid directly at the pharmacy. Reference retail prices (PVP) are published by Infarmed, Portugal's medicines regulator. You can find the current prices on each page of our medicines library (in Portuguese).

For example, the retail price of Mounjaro for a four-week pack is:

• €182.92 at the starting dose (2.5 mg);
• €244.80 to €430.46 at the higher doses.

Prices confirmed on 14 October 2026, on our Mounjaro price page (in Portuguese).

Blood tests

The doctor's request and review of your tests are included. The tests are done at the laboratory of your choice and paid for by you, directly or through your health insurance. The price depends on the laboratory and the tests requested.

Example cost

With Mounjaro, at prices of 14 and 16 October 2026.

The doctor only increases the dose if it is appropriate and well tolerated; each month's cost depends on the dose prescribed. The doctor and the consultation report tell you the estimated cost before you start.

Insurance

Piko has no agreements with insurers. Every consultation is invoiced with your tax number (NIF), and you can submit the invoice to your insurer; reimbursement depends on your policy.

Cancellations, rescheduling and refunds

If the doctor concludes at the first consultation that the programme is not right for you, we refund that consultation. You can reschedule a consultation free of charge up to 24 hours before. Pack consultations are not refundable, but they do not expire.

• Not eligible: if the doctor decides, at the first consultation, that you are not eligible for the programme, Piko refunds that consultation.
• Rescheduling: you can reschedule a consultation free of charge up to 24 hours before its time, in your patient area at app.piko.com. Consultations rescheduled or cancelled less than 24 hours ahead are charged in full.
• Lateness: there is a 7-minute grace period. After that, without prior notice, the consultation is ended and not refunded.
• Packs: pack consultations are not refundable, but they do not expire. You can use them later, whenever you like.
• Online purchases: can be cancelled with a refund up to 3 hours after payment (or 3 hours into the next working day, if the purchase is made outside opening hours). After that, there is no refund if the doctor has already issued a prescription.
• How you are refunded: to the credit or debit card used for payment, within 1 to 10 working days.

The Terms of use prevail.

Will the doctor prescribe me medication?

Not necessarily. A consultation does not guarantee a prescription. The doctor decides, case by case, whether medication is appropriate and safe for you. A plan of diet, physical activity and follow-up alone is a possible and valid outcome.

The doctor takes into account:

• your BMI and weight-related conditions;
• your medical and family history;
• the medication you already take, including psychiatric medication and anticoagulants;
• pregnancy, breastfeeding, plans to become pregnant and contraception;
• planned surgery;
• your blood pressure and heart rate, before the first prescription;
• blood test results, where there are any.

If the doctor delays the prescription

1. They explain why and what is needed (for example, blood tests or a document), where to get it and when to send it by.
2. If it does not arrive in time, you get an automatic reminder.
3. The doctor reviews what you send within 48 hours.
4. If everything is normal, the prescription is issued the same day.

If medication is prescribed

• Prescription: you receive an electronic prescription, which you can collect at any pharmacy. Prescriptions are monthly, and the next ones are issued at the follow-up consultations.
• Dose: you always start on a low dose, which only goes up after at least 4 weeks and if it is well tolerated.
• Contraception: with some medicines, the pill can be less effective after starting and after each dose increase; the doctor tells you what to do.
• Pregnancy: if you plan to become pregnant, the medication has to be stopped in advance. The doctor tells you when.
• Surgery or anaesthesia: if you have one booked, tell the anaesthetist you are on this treatment.
• Medicine out of stock: if a medicine is out of stock, the doctor may adjust the plan, including switching to another approved medicine. As there is no direct dose equivalence between medicines, the switch restarts on a low dose.

Piko does not sell or deliver medicines.

Which medicines can be prescribed?

Several medicines are approved in Portugal for weight management, all prescription-only. None is reimbursed by the SNS for weight loss. The choice, if any, is the doctor's, based on your health and weight-related conditions.

Ozempic (semaglutide) is reimbursed only for type 2 diabetes, under the special scheme in Portaria n.º 170/2025/1; it is not reimbursed for weight loss.

Not available in Portugal: retatrutide, which is still in clinical trials, and Wegovy tablets, which were approved in the European Union in July 2026 but are not yet sold in Portugal.

For information on each medicine, see the medicines library (in Portuguese). This page is for information and does not replace a medical assessment.

What results can I expect?

Results vary from person to person. In the main clinical trials, average weight loss after about 16 to 18 months was 15% to 19% with semaglutide (2.4 mg and 7.2 mg) and 15% to 21% with tirzepatide, always alongside diet and physical activity. These are averages, not guarantees.

What the studies show

These are the figures from each study's main analysis, which counts every participant, including those who stopped treatment. Among participants who took the treatment as planned, the averages are higher: for example, 20.7% with semaglutide 7.2 mg in STEP UP.

Limitations

• These are averages across the people studied: some lose much more, others much less.
• Participants had regular follow-up and changed their diet and physical activity.
• The trials excluded some people (for example, with certain conditions), so the results may not apply to you.
• These figures are for the medicines, not for Piko.

Piko does not set monthly weight targets or promise results.

Results of Piko's patients

Piko does not yet publish its own results data. When we do, we will state the number of patients, the period and the method.

What if I have side effects?

Talk to your nurse by chat or to your doctor. If you have a warning sign, do not wait for the chat: go to A&E, call SNS 24 (808 24 24 24) or, if your life is at risk, call 112. Piko is not an emergency service.

Common side effects

The most frequent with GLP-1 medicines are nausea, vomiting, diarrhoea, constipation, reflux and a feeling of fullness, especially at the start or after a dose increase. They usually ease over time.

What helps:

• small meals, stopping at the first sign of fullness;
• avoiding fatty and spicy meals;
• about 2 litres of water a day, unless your doctor advises otherwise;
• fibre and fluids from the start, to prevent constipation.

If the effects persist, the doctor may slow or pause the dose increase, lower the dose, prescribe medication for the symptoms or, if they are intolerable, stop the treatment. The video guide includes a video from the Clinical Director on side effects and another on hair loss.

Sick days

If you have vomiting or diarrhoea for more than 24 hours:

• skip that week's dose and talk to the team;
• contact SNS 24 or go to A&E if you are passing little urine, feel dizzy when standing up or the vomiting lasts more than 24 hours.

How to contact the clinical team

• Nurse by chat: working days, from 9:00 to 18:00, usually answering within a few minutes.
• Symptoms the nurse passes to the doctor: an urgent sign is seen by the doctor the same day; others get a medical decision within 48 hours.
• A consultation with the doctor before the planned date: book it at app.piko.com whenever you like.
• Out of hours: the chat's automatic reply tells you where to go. Call SNS 24 (808 24 24 24) or, in an emergency, 112.

Warning signs: go to A&E, or call SNS 24 or 112

• Severe, persistent abdominal pain, which may spread to the back.
• Vomiting that will not stop, or signs of dehydration: passing little urine, dizziness when standing up.
• Pain on the right side of the abdomen, with fever or yellowing of the skin and eyes.
• An allergic reaction: swelling of the face, lips or throat, difficulty breathing, a skin rash.
• Sudden loss of vision.
• Chest pain, severe shortness of breath or fainting, including during exercise.
• Severe hypoglycaemia, if you have diabetes.
• Mood changes, or thoughts of suicide or self-harm: go to A&E (psychiatric emergency) straight away or call 112.

Afterwards, let the Piko team know so the doctor can review your treatment.

Reporting a side effect

You can report any suspected side effect directly to Infarmed, through the RAM portal. The Piko team can also help you do it.

What happens after I lose weight?

Weight tends to come back when medication is stopped suddenly. So follow-up does not end when you reach your goal: the doctor agrees a maintenance phase with you, in which the medication is reduced gradually. Consultations become less frequent, usually every 3 to 6 months, or whenever you need one.

Maintenance applies once you reach your target weight, and goes in stages, decided case by case:

1. Stabilise. For about 3 months you stay on the same dose, to confirm your weight is stable and your new habits are settled.
2. Reduce. If your weight stays stable, the doctor gradually reduces the medication, with more focus on diet, strength training and sleep.
3. Try stopping. If there is no significant weight regain, you can try stopping the medication, with active follow-up afterwards.

At any stage, if your weight goes back up, your blood tests get worse or you lose control of your appetite, you go back to the previous stage.

• Maintenance consultations: as many as you need, usually every 3 to 6 months. You can use pack consultations, which do not expire. The doctor never suggests spacing out consultations just to cut costs.
• Discharge: when the goals are reached, the doctor issues a discharge note and you move to a six-monthly maintenance consultation.
• Report: you get a report after every consultation, including the last one, which you can give to your GP.
• What the studies say:
  • in a follow-up to STEP 1, people who stopped semaglutide regained, on average, about two thirds of the weight they had lost within a year (Wilding et al., Diabetes, Obesity and Metabolism, 2022);
  • in SURMOUNT-4, people who stopped tirzepatide regained some of the weight, while those who continued kept it off or lost more (Aronne et al., JAMA, 2024).
• Still available: the nutrition plan, the live sessions and the videos on food, exercise and what to do if your weight plateaus.

Blood tests

Piko's doctor may request blood tests to assess your health or the safety of the treatment, and goes through the results with you. The request and review are included in the programme. The tests are done at the laboratory of your choice and paid for by you, directly or through your insurance.

• When they are requested: the doctor always asks whether you have recent tests. If not, they request them alongside the decision; not having tests does not, on its own, delay the first prescription.
• What they usually include:
  • fasting glucose and HbA1c;
  • lipid profile;
  • liver and kidney function;
  • electrolytes, full blood count and TSH;
  • in some cases, other tests (for example, a urine test for people with diabetes or high blood pressure).
• Where to have them: at any clinical laboratory.
• What they cost: it depends on the laboratory and the tests requested. You pay the laboratory directly or through your health insurance.
• Review: the doctor reviews the results within 48 hours of you sending them, or at the next consultation, and explains them in the consultation report.

Full check-up with over 100 biomarkers

The full blood-test check-up is due to launch in November 2026. Until then, you can join the waiting list.

Your data

Your clinical data is processed and stored by Welcome Honesty Serviços Médicos Unipessoal, Lda., the healthcare provider, and is protected by professional confidentiality. The personal data collected on the website and payment data are processed by Lyvion Digital Solutions, Lda.

• Who processes your data:
  • Clinical data (questionnaire, consultation notes, prescriptions, tests): Welcome Honesty Serviços Médicos Unipessoal, Lda. It is seen only by the health professionals caring for you, who are bound by professional confidentiality.
  • Account, contact, payment and marketing data: Lyvion Digital Solutions, Lda., which runs the piko.com website.
• Who it is shared with:
  • subcontractors that provide services to Piko (for example, hosting, communications and payments), only as far as necessary and under contracts requiring appropriate security measures;
  • the authorities, only when the law requires it.
  • Piko does not sell your data or pass it to third parties for any other purpose.
• Where it is stored: on the IT systems of Piko and its subcontractors, with technical and organisational security measures.
• For how long: for as long as needed for the purposes it was collected for and to meet legal record-keeping obligations, including those that apply to clinical records. After that, it is deleted.
• Your rights: you can ask, at any time, for:
  • access to your data;
  • correction;
  • deletion;
  • portability;
  • restriction of processing;
  • objection;
  • withdrawal of consent, where processing is based on it.
• How to exercise your rights: email the Data Protection Officer at data@pikohealth.com, with the subject "Proteção de Dados Pessoais". Use the same address to report a suspected data breach.
• Complaints: if you believe your rights have not been respected, you can complain to Portugal's data protection authority, the Comissão Nacional de Proteção de Dados (CNPD).
• Recording consultations: the doctor asks for your consent before using the consultation note-taking assistant.

More in the Privacy policy.

How to compare Piko with other clinics

No clinic is best for everyone. When comparing, check who provides the care, how the consultation is done, how often you are followed up, the total price and the refund policy.

Questions to ask any clinic, Piko included:

1. Is the provider registered with the ERS? Under what number?
2. Is the first assessment a consultation with a named doctor, or just a questionnaire?
3. How often are there follow-up consultations, and who answers between them?
4. Is there a nutrition plan written by a nutritionist, and is it included in the price?
5. What do the first month and each month after cost, with and without medication?
6. Is there a refund if the doctor decides you are not eligible?
7. What happens if you have side effects out of hours?

Piko's answers are on this page. Our comparisons with other clinics are on the blog (in Portuguese) and are published by Piko, one of the clinics compared; they are not independent reviews.

What Piko does not do

• It does not provide urgent or emergency care.
• It does not hold in-person consultations.
• It does not sell or deliver medicines.
• It does not issue prescriptions without a medical consultation.
• It does not guarantee a prescription for any medicine.
• It does not guarantee results or set monthly weight targets.
• It does not yet sell the full check-up with over 100 biomarkers; launch is planned for November 2026.

Who writes and reviews Piko's content

Piko's health articles are written by the editorial team and reviewed by a doctor from the clinical team. Each article states who reviewed it and when. If an article changes after review, we send it back to the doctor or state that the reviewed version is the previous one. Read more about our editorial process.

Contacts and complaints

• Email: support@pikohealth.com
• Phone: +351 925 606 079
• Support hours: Monday to Friday, 9:00 to 18:00
• Data protection: data@pikohealth.com
• Patient area and booking: app.piko.com
• Healthcare provider's registered office: Rua António Oliveira, n.º 18, 2820-302 Charneca da Caparica, Almada
• Complaints Book: Livro de Reclamações Eletrónico
• Dispute resolution: disputes about healthcare can be taken to the ERS. The other bodies are listed on the Legal information page.
• Press: Press

Sources

• Entidade Reguladora da Saúde, register of establishments: www.ers.pt
• Infarmed, medicine prices (PVP) and adverse reaction reporting: www.infarmed.pt
• Wilding JPH et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1). N Engl J Med. 2021;384:989-1002.
• Jastreboff AM et al. Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1). N Engl J Med. 2022;387:205-216.
• Aronne LJ et al. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity (SURMOUNT-5). N Engl J Med. 2025;393:26-36.
• Wharton S et al. Once-weekly semaglutide 7·2 mg in adults with obesity (STEP UP): a randomised, controlled, phase 3b trial. Lancet Diabetes Endocrinol. 2025;13(11):949-963.
• Wilding JPH et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension. Diabetes Obes Metab. 2022;24:1553-1564.
• Aronne LJ et al. Continued Treatment With Tirzepatide for Maintenance of Weight Reduction (SURMOUNT-4). JAMA. 2024;331:38-48.